JP7328156B2 - Ultrasound diagnostic equipment, medical image processing equipment, and medical image processing program - Google Patents

Description

The embodiments disclosed in this specification and drawings relate to an ultrasonic diagnostic apparatus, a medical image processing apparatus, and a medical image processing program.

In echocardiography using ultrasonic diagnostic equipment, cardiac motion images such as 2D moving images based on two-dimensional (2D) scanning and 3D moving images based on three-dimensional (3D) scanning are processed using cardiac function analysis technology and myocardial wall motion tracking technology. Functional index values are obtained by analysis, and cardiac function evaluation is performed using these functional index values. As the 2D moving image, for example, a moving image obtained by depicting an apical long-axis image of an A4C image (apical 4-chamber image) or an A2C image (apical 2-chamber image) by 2D scanning is used. Furthermore, in recent years, it has become possible to acquire various functional index values specific to each heart chamber.

However, if the functional index values of a plurality of heart chambers are displayed on the screen at the same time, the displayed image becomes complicated, making it difficult for the user to grasp the desired functional index value and heart function state. For example, when simultaneously displaying volumetric rate (EF) and longitudinal global strain (GLS) information and chamber size information for both the left ventricle and the left atrium, a large number of numerical values are displayed on the screen. This makes it difficult to grasp the screen display.

In addition, since there are multiple definitions of EF and GLS in the atrium depending on the cardiac time phase, output information is greater than that of the EF and GLS of the ventricle. For this reason, when displaying the EF and GLS with multiple definitions of the atrium, the display becomes complicated, and it becomes difficult to evaluate and understand the cardiac function based on the function index value.

JP 2017-121520 A

One of the problems to be solved by the embodiments disclosed in the present specification and drawings is to provide an image that includes functional index values of a plurality of heart chambers and allows the user to easily and intuitively grasp the heart function state. is. However, the problems to be solved by the embodiments disclosed in this specification and drawings are not limited to the above problems. A problem corresponding to each effect of each configuration shown in the embodiments described later can be positioned as another problem.

An ultrasonic diagnostic apparatus according to an embodiment includes an acquisition unit and an image generation unit. The acquiring unit acquires the functional index value of each of the two heart chambers including the left ventricle included in the moving image of the heart. The image generator allocates the functional index values of the respective heart chambers to display dimensions for each heart chamber. In addition, the image generation unit performs color conversion on a two-dimensional coordinate space in which the function index values of the left ventricle are defined as outputs in association with predetermined normal and abnormal ranges of the function index values of the left ventricle. An image is generated by superimposing the suggestive image.

FIG. 1 is a block diagram showing a configuration example of an ultrasound diagnostic apparatus according to an embodiment; FIG. 3 is a block diagram showing an example of a function realized by a processor of a processing circuit; FIG. 4 is an explanatory diagram showing an example of a list image showing a plurality of function index values unique to the left ventricle; FIG. 10 is an explanatory diagram showing an example of a list image with limited display items, which is an image including functional index values of a plurality of heart chambers generated in the conventional technique; An explanatory diagram showing an example of a 2D cardiac function image according to the present embodiment. Explanatory drawing which shows an example of the modified example image of a 2D cardiac function image. Explanatory drawing showing an example of a 3D cardiac function image according to the present embodiment. FIG. 4 is an explanatory diagram showing an example of a 2D cardiac function image displayed as a transition image when the 3D cardiac function image is rotated around an axis. Explanatory drawing which shows an example of the modification image of a 3D cardiac function image. Explanatory drawing which shows an example of the time-series image which concerns on this embodiment.

Hereinafter, embodiments of an ultrasonic diagnostic apparatus, a medical image processing apparatus, and a medical image processing program will be described in detail with reference to the drawings.

(overall structure)
FIG. 1 is a block diagram showing a configuration example of an ultrasonic diagnostic apparatus 10 according to one embodiment. The ultrasonic diagnostic apparatus 10 can be used by being connected to an ultrasonic probe 20 , an input interface 21 and a display 22 . Note that the ultrasound diagnostic apparatus 10 may include at least one of the ultrasound probe 20 , the input interface 21 and the display 22 . The ultrasonic diagnostic apparatus 10 may be tablet type or smart phone type.

As shown in FIG. 1, the ultrasonic diagnostic apparatus 10 includes a transmission/reception circuit 11, a B-mode processing circuit 12, a Doppler processing circuit 13, an image generation circuit 14, an image memory 15, a storage circuit 16, a network connection circuit 17, and processing circuits. 18.

The transmission/reception circuit 11 has a transmission circuit and a reception circuit. The transmission/reception circuit 11 is controlled by the processing circuit 18 to control transmission directivity and reception directivity in transmission/reception of ultrasonic waves. Although FIG. 1 shows an example in which the transmitting/receiving circuit 11 is provided in the ultrasonic diagnostic apparatus 10, the transmitting/receiving circuit 11 may be provided in the ultrasonic probe 20. Both probes 20 may be provided.

The transmission circuit has a pulse generator, a transmission delay circuit, a pulser circuit, and the like, and supplies drive signals to the ultrasonic transducers. A pulse generator repeatedly generates rate pulses at a predetermined rate frequency to form a transmitted ultrasound wave. The transmission delay circuit adjusts the delay time for each piezoelectric transducer necessary to focus the ultrasonic waves generated from the ultrasonic transducers into a beam and determine the transmission directivity by adjusting each rate pulse generated by the pulse generator. give to Also, the pulsar circuit applies a drive pulse to the ultrasonic transducer at a timing based on the rate pulse. The transmission delay circuit arbitrarily adjusts the transmission direction of the ultrasonic beam transmitted from the piezoelectric transducer surface by changing the delay time given to each rate pulse.

The receiving circuit has an amplifier circuit, an A/D converter, an adder, etc., receives echo signals received by the ultrasonic transducers, and performs various processes on the echo signals to generate echo data. The amplifier circuit amplifies the echo signal for each channel and performs gain correction processing. The A/D converter A/D-converts the gain-corrected echo signal and gives the digital data a delay time necessary to determine the reception directivity. The adder adds the echo signals processed by the A/D converter to generate echo data. The addition processing of the adder emphasizes the reflection component from the direction corresponding to the reception directivity of the echo signal.

The B-mode processing circuit 12 receives the echo data from the receiving circuit, performs logarithmic amplification, envelope detection processing, etc., and generates data (B-mode data) in which the signal intensity is represented by brightness. The Doppler processing circuit 13 frequency-analyzes the velocity information from the echo data received from the receiving circuit, extracts the blood flow, tissue, and contrast agent echo components due to the Doppler effect, and collects the moving state information such as the average velocity, dispersion, and power. Generate extracted data (Doppler data) for the points.

The image generating circuit 14 generates ultrasonic image data based on echo signals received by the ultrasonic probe 20 . For example, the image generating circuit 14 generates, from the two-dimensional B-mode data generated by the B-mode processing circuit 12, two-dimensional B-mode image data representing the intensity of the reflected wave in luminance. In addition, the image generation circuit 14 converts the two-dimensional Doppler data generated by the Doppler processing circuit 13 into a two-dimensional color Doppler image as an average velocity image, a variance image, a power image, or a combination of these images representing movement state information. image data.

The image memory 15 is a memory for storing images generated by the processing circuit 18 . The storage circuit 16 has a configuration including a processor-readable recording medium such as a magnetic or optical recording medium or a semiconductor memory. A part or all of the program and data in the storage medium of the storage circuit 16 may be downloaded by communication via the network N, or may be provided to the storage circuit 16 via a portable storage medium such as an optical disc. . Some or all of the information stored in the storage circuit 16 is distributed and stored in at least one storage medium such as an external storage circuit or a storage circuit (not shown) of the ultrasound probe 20, or is replicated. may be stored.

The network connection circuit 17 implements various information communication protocols according to the form of the network N. FIG. The network connection circuit 17 connects the ultrasonic diagnostic apparatus 10 and other electric devices according to these various protocols. An electrical connection via an electronic network or the like can be applied to this connection. Here, the electronic network means all information communication networks using telecommunication technology, including wireless/wired LAN such as hospital backbone LAN (Local Area Network), Internet network, telephone communication line network, optical fiber communication network. , including cable and satellite communications networks.

The processing circuit 18 implements a function of centrally controlling the ultrasonic diagnostic apparatus 10 . In addition, the processing circuit 18 reads out and executes the medical image processing program stored in the storage circuit 16, thereby allowing the user to easily and intuitively grasp the cardiac function state including the functional index values of a plurality of heart chambers. A processor that executes processing for providing an image.

The ultrasonic probe 20 is detachably connected to the ultrasonic diagnostic apparatus 10 via a cable. Note that the ultrasonic probe 20 may be wirelessly connected to the ultrasonic diagnostic apparatus 10 .

As the ultrasonic probe 20, a two-dimensional array probe in which a plurality of ultrasonic transducers are arranged in the scanning direction (azimuth direction) and a plurality of elements are arranged in the lens direction (elevation direction) can be used. . For example, a 1.5D array probe, a 1.75D array probe, a 2D array probe, or the like can be used as this type of two-dimensional array probe.

Note that the ultrasonic probe 20 may be configured to be able to acquire volume data. In this case, the subject may be scanned three-dimensionally by the ultrasonic probe 20, which is a two-dimensional array probe, or by the ultrasonic probe 20, which is a one-dimensional ultrasonic probe in which a plurality of piezoelectric transducers are arranged in a line. The subject may be scanned two-dimensionally, or the subject may be scanned three-dimensionally by rotating the plurality of ultrasonic transducers. may oscillate to

When the ultrasound probe 20 can acquire volume data, the user can select a two-dimensional display mode (2D mode) for displaying any of a plurality of two-dimensional ultrasound images as a real-time moving image or a still image, and real-time acquisition. A four-dimensional display mode (4D mode) in which a three-dimensional ultrasound image is displayed as a moving image can be selected.

The input interface 21 includes, for example, a trackball, a switch, a button, a mouse, a keyboard, a touch pad that performs input operations by touching an operation surface, a non-contact input circuit using an optical sensor, a voice input circuit, and the like. It is implemented by an input device and outputs an operation input signal corresponding to a user's operation to the processing circuit 18 . The input interface 21 may be configured as an operation panel. In this case, the operation panel functions as a touch command screen and has, for example, a display, a touch input circuit provided near the display, and hard keys.

The display 22 is composed of a general display output device such as a liquid crystal display or an OLED (Organic Light Emitting Diode) display, and displays various information under the control of the processing circuit 18 . Note that the ultrasonic diagnostic apparatus 10 may not include at least one of the input interface 21 and the display 22 .

Note that, for example, when the ultrasonic diagnostic apparatus 10 is a stationary apparatus and includes the input interface 21 and the display 22, the input interface 21 may function as a touch command screen. Further, when the ultrasonic diagnostic apparatus 10 is a tablet-type or smartphone-type ultrasonic diagnostic apparatus 10, the input interface 21 and the display 22 may be integrated to form a touch panel.

Further, the ultrasonic diagnostic apparatus 10 may be connected to the medical image processing apparatus 30 and the image server 40 via the network N so that data can be exchanged with each other.

FIG. 2 is a block diagram showing an example of functions realized by the processor of the processing circuit 18. As shown in FIG. As shown in FIG. 2, the processor of processing circuit 18 implements analysis function 51 , index acquisition function 52 , range setting function 53 , and image generation function 54 . Each of these functions 51-54 is stored in the memory circuit 16 in the form of a program.

The analysis function 51 analyzes a plurality of consecutive frame images (hereinafter referred to as cardiac motion images) of the subject's heart to determine functions specific to each heart chamber for each of two or more heart chambers including the left ventricle. Find the index value.

Cardiac moving images generated by the ultrasonic diagnostic apparatus 10 based on data generated by the B-mode processing circuit 12 and the Doppler processing circuit 13 may be used in real time or post-process. In addition, the cardiac motion image may be generated by imaging the subject with other modalities such as an X-ray CT (Computed Tomography) device or an MRI (Magnet Resonance Imaging) device (not shown). Cardiac motion images generated by other modalities may be acquired directly from the other modalities via network N or indirectly via image server 40 .

Also, the function index value may be obtained by analyzing a cardiac motion image by an information processing device such as a workstation or the medical image processing device 30, another ultrasonic diagnostic device, or another modality. In this case, the ultrasonic diagnostic apparatus 10 may not have the analysis function 51 .

When the ultrasonic diagnostic apparatus 10 has the analysis function 51, the analysis function 51 first acquires, for example, a 2D moving image or a 3D moving image including a heart cavity over at least one cardiac cycle of the subject. Subsequently, the analysis function 51 extracts a plurality of regions of interest of the heart cavity including the left ventricle in at least one or more initial time phases of the cardiac motion image. Then, the analysis function 51 identifies the position in one cardiac cycle for each of the extracted regions of interest of the heart cavity, and obtains a global cardiac function index from the position of the region of interest of the heart cavity in a predetermined cardiac phase.

A 2D or 3D speckle-tracking echocardiography (STE) method is suitable as a localization method. In addition, as a global cardiac function index, EF (Ejection Fraction in the left ventricle, Emptying Fraction in the left atrium), which is the intracardiac cycle change rate of lumen volume, and longitudinal global strain ( global longitudinal strain (GLS) is preferred. Also, when using a 3D moving image, it is also possible to define a global area change ratio (GAC) for the interface between the endocardium and the middle layer.

The index acquisition function 52 is controlled by the image generation function 54 to acquire functional index values for each of a plurality of heart chambers included in the moving image of the heart. In the following description, an example is shown in which the index acquisition function 52 acquires the functional index values of at least two heart chambers including the left ventricle included in the moving image of the heart. The index acquisition function 52 is an example of an acquisition unit.

The range setting function 53 sets a predetermined normal and abnormal range for the function index value. The normal range and the abnormal range of function index values may be stored in the storage circuit 16 in advance, or may be provided by the user via the input interface 21 .

The image generation function 54 calculates a predetermined normality of a predetermined heart chamber function index among the plurality of heart chambers in a multi-dimensional coordinate space in which the function index values of a plurality of heart chambers are assigned to each dimension for each heart chamber. and the abnormal range, and the color-converted range suggestive image is superimposed. For example, the image generating function 54 first assigns the functional index values of the respective heart chambers to display dimensions for each heart chamber, and sets a two-dimensional coordinate space in which the functional index values of the left ventricle are defined as outputs. Then, the image generating function 54 generates an image by superimposing the range-indicative image obtained by color-converting the left ventricular function index value in association with the predetermined range of normality and abnormality in the two-dimensional coordinate space, display on the display 22. The image generation function 54 is an example of an image generation section.

Note that each function 52 - 54 of the processing circuit 18 may be provided in the medical image processing apparatus 30 . The medical image processing apparatus 30 may also have an analysis function 51 . When the analysis function 51 is provided, the medical image processing apparatus 30 acquires cardiac motion images of the subject from the ultrasonic diagnostic apparatus 10, the image server 40, or other modalities via the network N and obtains a functional evaluation value. demand. The medical image processing apparatus 30 generates an image in which the range suggestive image is superimposed on the two-dimensional coordinate space, and displays it on an image display device such as the display 22 or the display of the medical image processing apparatus 30 .

(Example of list image of character strings)
An image containing functional index values of a plurality of heart chambers generated in the conventional technique will now be described.

FIG. 3 is an explanatory diagram showing an example of a list image 101 showing a plurality of function index values unique to the left ventricle.

As described above, in echocardiography using an ultrasonic diagnostic apparatus, cardiac function evaluation is performed using function index values obtained by analyzing cardiac moving images such as 2D moving images and 3D moving images. The functional index values include volume information (End Diastolic Volume: EDV, End Systolic Volume: ESV, Ejection Fraction: EF) of the left ventricle (Left Ventricular: LV) by the modified-Simpson method, and speckle-tracking echocardiography (STE) method. including global longitudinal strain (GLS) information obtained in . It is known that EF and GLS information can be obtained by, for example, a fully automated Auto-EF application (see FIG. 3).

In addition to the left ventricle, for example, the left atrium (LA), the volume change rate (Emptying Fraction: EF) information and GLS information acquisition and analysis by 2D-STE method using 2D moving images is possible. As for the left ventricle, it is known that the 3D-STE method can acquire strain information such as three-dimensional EF using 3D moving images and GLS and global area change ratio (GAC).

Moreover, in recent years, a cardiac function analysis function based on three-dimensional EF of the right ventricle (RV) and right atrium (RA) has also been provided. In addition, acquisition of GLS by the 2D-STE method is possible in four cavities, LV, LA, RV and RA, by using A4C images. Furthermore, simultaneous analysis of multiple heart chambers using EF has also come to be performed.

However, if the functional index values of a plurality of heart chambers are displayed on the screen at the same time, the displayed image becomes complicated, making it difficult for the user to grasp the desired functional index value and heart function state. For example, consider displaying EF and GLS information and chamber size information simultaneously for both the left ventricle and the left atrium. In this case, a list image of the left atrium similar to the list image 101 shown in FIG. For this reason, the user is exposed to a list of many character strings, and it is difficult to grasp the heart function state of the subject.

In addition, since there are multiple definitions of EF and GLS in the atrium depending on the cardiac time phase, output information is greater than that of the EF and GLS of the ventricle. For example, there are three types of EF (fractional volume change) for the left atrium: total EF, active EF, and passive EF. Therefore, when multiple types of EF and GLS of the atrium are displayed, the display becomes complicated, and it becomes difficult to evaluate and understand the cardiac function based on the function index value.

As a method of avoiding this kind of complication when simultaneously displaying the functional index values of a plurality of heart chambers on the screen, a method of limiting the display items and displaying them at the same time is conceivable.

FIG. 4 is an explanatory diagram showing an example of list images 102 and 103, which are images including functional index values of a plurality of heart chambers generated in the conventional technique, and in which display items are limited. In the example shown in FIG. 4, the list image 102 is an image showing a list of partial items of the function index values for the left ventricle, and the list image 103 is for the left atrium.

As shown in FIG. 4, by limiting the display items to be displayed in the list images 102 and 103, the number of character strings is reduced compared to the case where two list images corresponding to the list image 101 shown in FIG. 3 are displayed side by side. can be reduced, and the user's visibility is improved. However, as is clear from FIG. 4, even if the display items are limited, the situation in which a large number of character strings are listed on the screen has not been improved, and the user still has to grasp the heart function state of the subject. difficult to do In addition, since the display items are limited, the amount of information that can be confirmed is reduced, resulting in deterioration in diagnostic accuracy. In the first place, even if the display items are limited, it is extremely difficult to intuitively understand the relationship of information between different heart chambers by comparing the list image 102 and the list image 103 in which only numerical values are listed. is.

Therefore, the processing circuit 18 of the ultrasonic diagnostic apparatus 10 according to the present embodiment generates an image that includes functional index values of a plurality of heart chambers and allows the user to easily and intuitively grasp the heart function state, and displays the image on the display 22. display.

(2D plot)
FIG. 5 is an explanatory diagram showing an example of a 2D cardiac function image 61 according to this embodiment. As shown in FIG. 5, the image generation function 54 may generate a 2D cardiac function image 61 in which the same global cardiac function index is assigned to display dimensions for each heart chamber and plotted in a two-dimensional coordinate space.

The 2D cardiac function image 61 shown in FIG. 5 uses the volume change rate (EF) as the same global cardiac function index, and the volume change rate (left ventricular ejection fraction) of the left ventricle, which is often emphasized in cardiac function evaluation. , LVEF) as the output dimension and the left atrium volume change rate (LAEF) as the input dimension. The input dimension may be the right ventricular volume fraction (RVEF).

In addition, the image generation function 54 superimposes a range suggestive image 61a, which is a color 2D mapping image obtained by color-converting the predetermined normal and abnormal ranges for the function index values assigned to the output dimensions, onto the two-dimensional coordinate space. and plotted on the range suggestive image 61a. In this case, the input dimension should be assigned a range of possible values for the corresponding heart chamber. Based on the LVEF guideline value, in FIG. An example is shown in which color range suggestive images 61a using green, yellow, and red are superimposed.

Further, the image generation function 54 may superimpose an image indicating a predetermined range of normality and abnormality for each function index value on the 2D cardiac function image 61 . FIG. 5 shows a case where a normal threshold line 62 indicating 55%, which is the threshold of the normal range of LVEF, and an abnormal threshold line 63 indicating 35%, which is the threshold of the abnormal range, are superimposed on the 2D cardiac function image 61. I gave an example.

Furthermore, the image generation function 54 may label multiple types of volumetric change rates related to the atria in the 2D cardiac function image 61 and plot them on the two-dimensional coordinate space at the same time. FIG. 5 shows an example of plotting the total-EF and active-EF of the left atrium by labeling the type of EF with "t" for total-EF and "a" for active-EF.

Further, in this case, the image generation function 54, as shown in FIG. An image 64 may be generated and included in the 2D cardiac function image 61 .

Here, the total-EF (Emptying Fraction) (EFt) of the left atrium is given by EFt=100*(Vmax-Vmin)/Vmax [%] (where V represents the volume of the left atrium). Also, the left atrium active-EF (EFa) is given by EFa=100*(VpreA-Vmin)/VpreA[%]. Vmax (maximum volume), Vmin (minimum volume), and VpreA (pre-systolic atrial volume) are determined from the curve of left atrial volume over time during the cardiac cycle.

Note that the atrial volume in the case of the A4C image and the A2C image alone is plotted as the value of one slice for both the left ventricle LV and the left atrium LA. When synthesizing the results of the A4C image and the A2C image, both the left ventricle LV and the left atrium LA are plotted as synthesized values by the modified Simpson method.

The time phase corresponding to VpreA is obtained by time differentiation of the volume time change curve disclosed by Zareian et al. determined by the method. At this time, when combining the results of the A4C image and the A2C image, the VpreA time phase is determined for each cross section and the combined VpreA value is obtained by the modified Simpson method.

Moreover, the 2D cardiac function image 61 is preferably displayed simultaneously with the cardiac ultrasound images as shown in FIGS. 3 and 4 . At this time, information indicating the position of the region of interest used when obtaining the functional index may be displayed at the same time.

According to the 2D cardiac function image 61, the user can grasp the functional index values very easily and intuitively without being troubled by enumerating the numbers compared to the case where the numerical values of the functional index values are enumerated. be able to. In addition, since the 2D cardiac function image 61 is superimposed with the range suggestive image 61a, which is a color 2D mapping image obtained by color-converting the normal and abnormal ranges, the user can display the range suggestive image 61a corresponding to the position of the plot. The heart function state of the subject can be immediately grasped just by visually recognizing the color of .

Further, according to the 2D cardiac function image 61, the user can select, via the selection reception image 64, whether to simultaneously display multiple types of functional index values of the same heart chamber or to display a single type. be. Further, even when multiple types of functional index values for the same heart chamber are displayed at the same time, the 2D cardiac function image 61 allows the user to easily and intuitively grasp the relationship between the various functional index values. In addition, the heart function state of the subject can be immediately grasped simply by visually recognizing the color of the range suggestive image 61a corresponding to the position of each plot.

FIG. 6 is an explanatory diagram showing an example of a modified image 65 of the 2D cardiac function image 61. As shown in FIG.

A modified image 65 of the 2D cardiac function image 61 uses GLS, which is one strain index, as the same global cardiac function index, and defines the GLS of the left ventricle as the output dimension and the GLS of the left atrium as the input dimension. It is an example of an image plotted in a two-dimensional coordinate space.

As with the 2D cardiac function image 61, for the modified image 65, -20% or less, which is regarded as a healthy value, is set as a normal range based on the LVGLS guideline value, while various cardiac abnormal values are set. It is preferable to superimpose a color range suggestive image 61b using green, yellow, and red like a traffic light, with an abnormal range of -15% (or -10%) or more. Further, the image generation function 54 may superimpose a normal threshold line 66 and an abnormal threshold line 67 of LVGLS on the modified image 65 as well as the 2D cardiac function image 61 (see FIG. 6).

In addition, as shown in FIG. 6, the image generation function 54 may further superimpose a straight line 68 of LVGLS=-LAGLS on the modified image 65 . In this case, the user can more easily grasp the relationship between the plot positions.

In addition, the image generation function 54 simultaneously displays the strain index of each time phase of ventricular systole and atrial systole regarding the atrium in the modified image 65 of the 2D cardiac function image 61, labeling the time phase type, and displaying it in a two-dimensional coordinate space. can be plotted above. FIG. 6 shows an example of plotting by labeling the time phase types of LAGLS, such as "s" for LAGLSs and "a" for LAGLSa.

As shown in FIG. 6, similarly to the 2D cardiac function image 61, in the modified image 65 as well, there is a function for receiving a user's selection as to whether to plot multiple types of LAGLS simultaneously or to plot only one of them. A selection acceptance image 69 may be included.

where LAGLSs is the systolic peak value (Max value). Also, LAGLSa is given by LAGLSa=LAGLSs-Sa', where Sa' is the value in the a' phase (VpreA phase).

Note that the atrial volume in the case of the A4C image and the A2C image alone is plotted as the value of one slice for both the left ventricle LV and the left atrium LA. When synthesizing the results of the A4C image and the A2C image, the average GLS values of both the left ventricle LV and the left atrium LA should be plotted.

Furthermore, the image generation function 54 may generate a plurality of two-dimensional coordinate spaces in which at least one of the function index values assigned to the display dimensions is different from each other, and display them side by side on the display 22 . Specifically, the image generation function 54 may generate both the 2D cardiac function image 61 and the modification image 65 and display them side by side on the display 22 .

Although the modified example image 65 shows an example in which GLS is used as the same global strain index, other function index values such as GAC may be used as the same global strain index.

The modified image 65 shown in FIG. 6 can also provide the same effect as the 2D cardiac function image 61 .

(3D plot)
FIG. 7 is an explanatory diagram showing an example of a 3D cardiac function image 71 according to this embodiment.

As shown in FIG. 7, the image generating function 54 may generate a 3D cardiac function image 71 in which the same global cardiac function index is assigned to display dimensions for each heart chamber and plotted in a three-dimensional coordinate space. In this case, the image generation function 54 sets the functional index value of the left ventricle on the vertical axis (eg, z-axis), and the functional index values of the other two heart chambers on two axes perpendicular to the vertical axis (eg, x-axis and y-axis). ) to set a three-dimensional coordinate space.

The 3D cardiac function image 71 shown in FIG. 7 uses the volumetric rate of change (EF) as the same global cardiac function index, assigns the EF of the left ventricle to the vertical axis as the output dimension and fixes it, and the EF of the left atrium and the EF of the right atrium. This is an example of an image plotted in a three-dimensional coordinate space with the EF of the ventricle as an input dimension.

A 3D cardiac function image 71 includes images 72, 73, and 74 for emphasizing values on each axis in order to facilitate understanding of function index values corresponding to plotted positions. FIG. 7 shows an example in which the image for emphasis is "()" (see LVEF "(45)", LAEFt "35", and RVEF "25" in FIG. 7). can be a figure enclosing the value corresponding to the plot position. In addition, as a method of emphasizing the values corresponding to the plot positions, instead of the images 72, 73, and 74, the display mode (size, font, thickness, brightness, etc.) of the values corresponding to the plot positions is different from other values. You can let

A different colored vertical line may also be attached from the plot to each axis. For the sake of convenience, FIG. 7 shows that each perpendicular line has a different color by making the line type different from that of a straight line, a dashed line, and a one-dot chain line. In addition, by setting the color of the character string of the value of each axis and the character string of the label of each axis to the same color as the color of the perpendicular line, the user can easily grasp the function index value corresponding to the plot position. can be done. In FIG. 7, the solid line surrounding the area containing "LVEF" is a line shown for convenience in explaining that the character strings in the area within the solid line are colored in the same color. 22 is not displayed. The same applies to the dashed line surrounding the region containing "LAEF" and the dashed-dotted line surrounding the region containing "RVEF".

One axis of the 3D cardiac function image 71 shown in FIG. 7 is the left atrium volume change rate (LAEF), which is a function index value for which multiple types are defined. For this reason, as in FIGS. 5 and 6, the image generation function 54 may label and plot the types of LAEFt and LAEFa also in the 3D cardiac function image 71, and at this time, both types may be plotted at the same time. Alternatively, a selection acceptance image 75 may be generated and included in the 3D cardiac function image 71 for accepting the user's selection of whether to plot only one type.

The 3D cardiac function image 71 shown in FIG. 7 can also provide the same effect as the 2D cardiac function image 61 . Further, according to the 3D cardiac function image 71, since the functional index values of the three heart chambers can be confirmed at once, the cardiac function state of the subject can be grasped more accurately than the 2D cardiac function image 61. . In addition, according to the 3D cardiac function image 71, although the functional index values of the three heart chambers are displayed at the same time, the user may be troubled by listing numbers like in the conventional image. None.

FIG. 8 is an explanatory diagram showing an example of a 2D cardiac function image displayed as a transition image when the 3D cardiac function image 71 is rotated about the axis 76 as the central axis.

The image generation function 54 may generate an image by rotating the 3D cardiac function image 71 at an angle according to a user's instruction, with an axis 76 parallel to the longitudinal axis of the 3D cardiac function image 71 as a central axis.

Further, the image generation function 54 may be capable of changing the viewpoint of the 3D cardiac function image 71 in accordance with user instructions via the input interface.

When the perspective of the 3D cardiac function image 71 is set not from the oblique perspective of the cube (see FIG. 7) but from the front, the 3D cardiac function image 71 is rotated around an axis 76 parallel to the vertical axis. Then, when the RVEF is parallel to the depth direction, a 2D cardiac function image with only the LAEF on the horizontal axis appears. Similarly, when the LAEF is parallel to the depth direction, a 2D cardiac function image with only the RVEF on the horizontal axis appears. (See Figure 8).

This 2D cardiac function image can be said to be an image corresponding to the 2D cardiac function image 61 shown in FIG. For this reason, the image generation function 54 superimposes a range suggestive image 61a (see FIG. 5), which is a color 2D mapping image, on the 2D new function image that appears by rotating the 3D cardiac function image 71 about the axis 76. good too.

By making the 3D heart function image 71 rotatable around the axis 76, the user can simultaneously display the function evaluation values of three heart chambers, or display the function evaluation values of two desired heart chambers on the 2D heart. It can also be displayed as a functional image. In addition, when the range suggestive image 61a is superimposed when the 2D cardiac function image is obtained, the user can simultaneously display the functional evaluation values of the three heart chambers to understand the whole, or the 2D cardiac function image. is displayed to confirm the positional relationship between the range suggestive image 61a and the plot, the heart function state of the subject can be more easily grasped.

FIG. 9 is an explanatory diagram showing an example of a modified image 80 of the 3D cardiac function image 71. As shown in FIG.

A modified image 80 of the 3D cardiac function image 71 includes a 3D cardiac function image 81 and an LVEF value image 82 indicating the EF of the left ventricle. In the 3D cardiac function image 81, the EF of the left atrium is used instead of the EF of the left ventricle assigned to the vertical axis of the 3D cardiac function image 71, and the EF of the right atrium, right ventricle, and left atrium are assigned to each axis. be done. The EF assigned to the vertical axis is preferably the left atrial or right ventricular EF. Note that the two-dot chain line in the 3D cardiac function image 81 of the modified image 80 corresponds to a color different from that of the straight line and broken line. In this case, in the modified image 80, the 3D cardiac function image 81 and the LVEF value image 82 of the EFs of the right atrium, right ventricle, and left atrium are simultaneously displayed, for example, in parallel (see FIG. 9).

The image generating function 54 has a character string indicating the left ventricular EF, an image having brightness corresponding to the left ventricular EF, and a color corresponding to the left ventricular EF as an LVEF value image 82 indicating the left ventricular EF. Generate at least one of the images. FIG. 9 shows an example in which the LVEF value image 82 is a color bar corresponding to the EF of the left ventricle and is colored in the same manner as the range suggestive image 61a.

In addition, the image generation function 54 may superimpose the normal threshold line and the abnormal threshold line on the LVEF value image 82, and may also generate an image for emphasizing the LVEF value corresponding to the plot of the 3D cardiac function image 81. (See “(45)” of the LVEF value image 82 in FIG. 9) may be superimposed. Further, the image generation function 54 superimposes an image 83 (see the arrow in FIG. 9) indicating the position on the LVEF value image 82 of the LVEF value corresponding to the plot of the 3D cardiac function image 81 on the LVEF value image 82. You may

A modified image 80 of the 3D cardiac function image 71 shown in FIG. 9 can also provide the same effect as the 3D cardiac function image 71 . Further, according to the modified image 80, the functional index values of the four heart chambers can be confirmed at once, so that the user can grasp the cardiac functional state of the subject more accurately than the 3D cardiac functional image 71. can be done. Moreover, according to the modified image 80, although the functional index values of the four heart chambers are displayed at the same time, the user is not troubled by the enumeration of numbers as in the conventional image. .

(Time series display)
FIG. 10 is an explanatory diagram showing an example of a time-series image 90 according to this embodiment.

The image generation function 54 simultaneously plots a plurality of functional index values with different time series obtained based on moving images of the heart captured in different time series, such as before and after treatment and before and after load, for the same subject. may FIG. 10 shows an example in which three plots 91, 92, and 93 are simultaneously displayed in reverse chronological order on a modified image 65 of the 2D cardiac function image 61 shown in FIG. Ta.

Also, the plurality of plots 91, 92, 93 whose time series are different from each other should be labeled according to their time series. FIG. 10 shows an example of a case where the newer the corresponding time series is, the lighter the hatching is applied to each plot, so that the newer the corresponding time series is, the brighter the plot is perceived by the user. In addition, the image generation function 54 may further superimpose an image showing the direction of time passage between a plurality of plots 91, 92, 93 with different time series. FIG. 10 shows an example in which an arrow 94 is superimposed as an image indicating the direction of passage of time.

According to the time series image 90, a plurality of function index values with different time series can be confirmed at the same time. Therefore, the user can easily and intuitively grasp the temporal change in the functional index value of the subject. In addition, by confirming the change in color of the range-indicating image 61b corresponding to each position of a plurality of plots with different time series, it is possible to immediately grasp the time change of the heart function state of the subject. Therefore, according to the time-series images 90, the user can easily diagnose the subject, evaluate the past treatment plan, formulate a future treatment plan, and set the load in the load test. and can be done accurately.

FIG. 10 shows an example of a case where display of a plurality of plots with different time series is applied to a 2D cardiac function image. , or a variant image 80 thereof.

According to at least one embodiment described above, it is possible to provide an image that includes functional index values of a plurality of heart chambers and allows the user to easily and intuitively grasp the heart function state.

In the above embodiment, the word "processor" is, for example, a dedicated or general-purpose CPU (Central Processing Unit), a GPU (Graphics Processing Unit), or an application specific integrated circuit (ASIC), Circuits such as programmable logic devices (e.g., Simple Programmable Logic Devices (SPLDs), Complex Programmable Logic Devices (CPLDs), and Field Programmable Gate Arrays (FPGAs)) means. When the processor is, for example, a CPU, the processor reads out and executes programs stored in a memory circuit to realize various functions. Also, if the processor is an ASIC, for example, instead of storing the program in the memory circuit, a function corresponding to the program is directly incorporated as a logic circuit within the circuit of the processor. In this case, the processor implements various functions by hardware processing that reads out and executes programs built into the circuit. Alternatively, the processor can implement various functions by combining software processing and hardware processing.

Further, in the above embodiments, an example of a case where a single processor of the processing circuit realizes each function is shown, but a processing circuit is configured by combining a plurality of independent processors, and each processor realizes each function. good too. Further, when a plurality of processors are provided, a memory circuit for storing programs may be provided individually for each processor, or one memory circuit may collectively store programs corresponding to the functions of all processors. good too.

While several embodiments have been described, these embodiments are provided by way of example and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, changes, and combinations of embodiments can be made without departing from the scope of the invention. These embodiments and their modifications are included in the scope and spirit of the invention, as well as the scope of the invention described in the claims and equivalents thereof.

10 Ultrasound diagnostic device 18 Processing circuit 21 Input interface 22 Display 30 Medical image processing device 52 Index acquisition function 54 Image generation function 61 2D cardiac function images 61a, 61b Range suggestive images 62, 66 Normal threshold line (image showing normal range )
63, 67 Abnormality threshold line (image showing the extent of abnormality)
64, 69, 75 Selection reception image 71 3D cardiac function image 76 Axis 90 Time-series images 101, 102, 103 List image of conventional function index values

Claims (18)

an acquisition unit that acquires a functional index value of each of the two heart chambers including the left ventricle included in the moving image of the heart;
The function index values of the respective heart chambers are assigned to display dimensions for each heart chamber, and the function index values of the left ventricle are defined in advance for a two-dimensional coordinate space defined as the output of the function index values of the left ventricle. and an image generation unit that generates an image in which a color-converted range suggestive image is superimposed in association with the abnormal range,
Ultrasound diagnostic equipment with. The acquisition unit
Further obtain a functional index value of one heart chamber,
The image generator is
setting a three-dimensional coordinate space in which the functional index value of the left ventricle is assigned to the vertical axis and the functional index values of the other two heart chambers are assigned to two axes orthogonal to the vertical axis; Generate an image superimposed with an image showing a predetermined normal and abnormal range for each functional index value,
The ultrasonic diagnostic apparatus according to claim 1. the other two heart chambers are the right ventricle and the left atrium;
The ultrasonic diagnostic apparatus according to claim 2. The image generator is
generating an image by rotating the image in the three-dimensional coordinate space at an angle according to a user instruction, with an axis parallel to the vertical axis as a central axis;
The ultrasonic diagnostic apparatus according to claim 2 or 3. The image generation unit
generating an image in which the range suggestive image is superimposed on the two-dimensional coordinate space when one axis and the depth direction are parallel when rotating the image in the three-dimensional coordinate space;
The ultrasonic diagnostic apparatus according to claim 4. The acquisition unit
Obtaining the functional index value of the remaining one heart chamber,
The image generator is
setting a three-dimensional coordinate space in which the right atrium, the right ventricle, and the left atrium are allocated to each dimension, generating an image of the three-dimensional coordinate space, and generating an image showing the function index value of the left ventricle; display both images side by side on the display unit,
The ultrasonic diagnostic apparatus according to any one of claims 2 to 5. The image generator is
The image indicating the function index value of the left ventricle includes a character string indicating the function index value of the left ventricle, an image having luminance corresponding to the function index value of the left ventricle, and generating at least one of the images having color;
The ultrasonic diagnostic apparatus according to claim 6. The acquisition unit
obtaining at least the function index value of the left ventricle and a plurality of types of volume change rates relating to the atrium;
The image generator is
labeling the types of the plurality of types of volumetric change rate and simultaneously generating an image shown on the coordinate space;
The ultrasonic diagnostic apparatus according to any one of claims 1 to 7. The acquisition unit
obtaining at least the function index value of the left ventricle and the strain index in each phase of ventricular systole and atrial systole with respect to the atrium;
labeling the temporal type of the strain index and simultaneously generating an image shown on the coordinate interval;
The ultrasonic diagnostic apparatus according to any one of claims 1 to 8. wherein the functional index value of each heart chamber includes a left ventricular ejection fraction (Ejection Fraction);
The ultrasonic diagnostic apparatus according to any one of claims 1 to 9. wherein the functional index value for each heart chamber comprises Global Longitudinal Strain (GLS);
The ultrasonic diagnostic apparatus according to any one of claims 1 to 10. wherein the functional index value for each heart chamber comprises a Global Area Change ratio (GAC);
The ultrasonic diagnostic apparatus according to any one of claims 1 to 11. The image generator is
generating a plurality of the coordinate spaces in which at least one of the function index values assigned to the display dimensions is different from each other and displaying them in parallel on the display unit;
The ultrasonic diagnostic apparatus according to any one of claims 1 to 12. The acquisition unit
Acquiring a plurality of functional index values with different time series obtained based on moving images of the heart captured in different time series of the same subject as the functional index values of the respective heart cavities,
The image generator is
generating an image showing the plurality of functional index values in different time series from each other in the coordinate space at the same time by labeling the time series;
The ultrasonic diagnostic apparatus according to any one of claims 1 to 13. The image generator is
An image showing the direction of time passage between the plurality of function index values is further superimposed on the image showing the plurality of function index values different in time series from each other on the coordinate space at the same time by labeling the time series. do,
The ultrasonic diagnostic apparatus according to claim 14. an acquisition unit that acquires a functional index value of each of the two heart chambers including the left ventricle included in the moving image of the heart;
The function index values of the respective heart chambers are assigned to display dimensions for each heart chamber, and the function index values of the left ventricle are defined in advance for a two-dimensional coordinate space defined as the output of the function index values of the left ventricle. and an image generation unit that generates an image in which a color-converted range suggestive image is superimposed in association with the abnormal range,
A medical image processing device with to the computer,
obtaining a functional index value for each of two heart chambers including the left ventricle contained in the moving image of the heart;
a step of assigning the functional index values of the respective heart chambers to display dimensions for each heart chamber and setting a two-dimensional coordinate space in which the functional index values of the left ventricle are defined as outputs; and for the two-dimensional coordinate space. generating an image in which a color-converted range suggestive image is superimposed in association with a predetermined range of normality and abnormality of the functional index value of the left ventricle;
A medical image processing program for executing an acquisition unit that acquires a functional index value of each of a plurality of heart chambers included in a moving image of the heart;
a range of normality and abnormality determined in advance for the functional index of a predetermined heart chamber among the plurality of heart chambers in a multidimensional coordinate space in which the functional index values of the plurality of heart chambers are assigned to each dimension for each heart chamber; an image generation unit that generates an image in which the color-converted range suggestive image is superimposed in association with the
Ultrasound diagnostic equipment with.